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FULL TEXT OF EXECUTIVE ORDER FROM THE WHITE HOUSE

EXECUTIVE ORDER
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ENSURING ENFORCEMENT AND IMPLEMENTATION OF ABORTION RESTRICTIONS IN THE
PATIENT PROTECTION AND AFFORDABLE CARE ACT
By the authority vested in me as President by the Constitution and the laws of the United States of
America, including the “Patient Protection and Affordable Care Act” (approved March __, 2010), I hereby
order as follows:
Section 1. Policy.
Following the recent passage of the Patient Protection and Affordable Care Act (“the Act”), it is necessary
to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion
services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent
with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The
purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and
procedures to achieve this goal and to make certain that all relevant actors—Federal officials, state officials
(including insurance regulators) and health care providers—are aware of their responsibilities, new and
old.
The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those
restrictions to the newly-created health insurance exchanges. Under the Act, longstanding Federal laws to
protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub.
L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health
care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage
of, or refer for abortions.
Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the
Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the
Office of Personnel Management (OPM).
Section 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges. The
Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion
services (except in cases of rape or incest, or when the life of the woman would be endangered) in the
health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and
accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans
(except in cases of rape or incest, or when the life of the woman would be endangered) and requires state
health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies
in accordance with generally accepted accounting principles, OMB funds management circulars, and
accounting guidance provided by the Government Accountability Office.
I hereby direct the Director of OMB and the Secretary of HHS to develop, within 180 days of the date of
this Executive Order, a model set of segregation guidelines for state health insurance commissioners to use
when determining whether exchange plans are complying with the Act’s segregation requirements,
established in Section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines
shall also offer technical information that states should follow to conduct independent regular audits of
insurance companies that participate in the health insurance exchanges. In developing these model
guidelines, the Director of OMB and the Secretary of HHS shall consult with executive agencies and
offices that have relevant expertise in accounting principles, including, but not limited to, the Department
of the Treasury, and with the Government Accountability Office. Upon completion of those model
guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will
have the force of law, to interpret the Act’s segregation requirements, and shall provide guidance to state
health insurance commissioners on how to comply with the model guidelines.
Section 3. Community Health Center Program.
The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional
Federal funds for the community health center program. Existing law prohibits these centers from using
federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman
would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing
 the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations
of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby
direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware
of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions
should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and
issuing new interpretive rules.
Section 4. General Provisions.
(a) Nothing in this Executive Order shall be construed to impair or otherwise affect: (i) authority granted
by law or presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the
Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This Executive Order shall be implemented consistent with applicable law and subject to the availability
of appropriations.
(c) This Executive Order is not intended to, and does not, create any right or benefit, substantive or
procedural, enforceable at law or in equity against the United States, its departments, agencies, entities,
officers, employees or agents, or any other person.
THE WHITE HOUSE,